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A toothache is pain in or around a tooth usually caused by cavities, a fracture, or gum disease. Many — but not all — of these must be treated by a dentist, and some are dental emergencies.
The fastest way to stop a toothache at home is by taking ibuprofen (Advil) or another NSAID, like aspirin. NSAIDs are the best painkillers for toothache.
If you have a toothache that lasts longer than 1-2 days, is severely painful, causes your face to droop, or is accompanied by fever, pain on opening your mouth, or an earache, contact your dentist right away.
Your dentist may suggest treatments such as a dental filling, an extraction, or a root canal for a toothache caused by tooth decay.
To prevent toothaches from cavities, practice good oral hygiene, use a remineralizing toothpaste that contains hydroxyapatite or fluoride, avoid cavity-causing foods and drinks, and never skip dental checkups.
When you face unbearable tooth pain, there are two things to do right away:
- Stop the toothache
- Determine how soon you need to see a dentist
Let’s look at how to stop your toothache fast, common causes of tooth pain, home remedies, and treatments your dentist may prescribe.
Toothache symptoms may include:
- Pain in the teeth that can be described as throbbing, sharp, and/or constant
- Pain that changes when you bite down, push on the tooth with your finger, or tap the tooth
- Pain that gets worse when you lie down
- Swelling of the gums around the tooth
- Smelly drainage from a tooth infection
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How to Stop Tooth Pain Fast
What is the fastest way to stop a toothache at home? The fastest way to stop a toothache at home is to take effective pain medication, like ibuprofen. NSAIDs, which reduce inflammation, are better for tooth pain than other painkillers.
For fast relief, try the Advil toothache trick recommended by dentists:
- Take 3 Advil (600 milligrams)
- 3 times a day
- For 3 days
Best Toothache Painkillers
Ibuprofen is the best painkiller for toothache. If ibuprofen is not working for your toothache, try aspirin, which is also an NSAID (non-steroidal anti-inflammatory drug).
Acetaminophen (Tylenol) is not well-suited for tooth pain because is not an NSAID and will not reduce inflammation that causes your pain. In general, non-NSAIDs and even opioids aren’t very effective for toothache pain.
If over-the-counter painkillers are not working for your toothache, call your dentist right away. You may need another medication, such as an antibiotic, in preparation for having the tooth pain fixed.
Common Causes of Toothache
A toothache is any pain in or around your teeth that may be caused by:
- Tooth decay/cavities
- Tooth abscesses
- Fractured tooth
- Root sensitivity
- Bruxism/teeth grinding
- Damaged or lost filling
- Adult or wisdom teeth eruption
- Gum disease
- Sinus infection (sinusitis)
- Failed dental work
- Food stuck in teeth
Cavities, or dental caries, cause tooth pain as bacteria destroy tooth enamel, then dentin. The acids excreted by cavity-causing bacteria cause inflammation when they reach the dentin and trigger swelling.
Tooth pain is unique, in part because swelling in the pulp has no place to expand, causing excruciating pain until the inflammation and swelling go down.
A tooth abscess (periapical abscess) is a pocket of pus at the tip of the tooth root as a result of a bacterial infection. Tooth abscesses cause extreme tooth pain.
A gum abscess (periodontal abscess) is a similar pocket within the gums that can also cause significant tooth pain.
Tooth abscesses often occur after trauma to the teeth or when the infection in untreated cavities continues to grow. Gum abscesses are more frequently a result of advanced gum disease.
Treatment and home remedies for dental abscess differ depending on the type of abscess.
Injury or trauma to a tooth can cause it to fracture or chip. A tooth fracture can cause severe tooth pain when you bite down, as well as severe tooth sensitivity to hot and cold foods or drinks.
Mild, infrequent tooth pain may be caused by tooth root sensitivity. If your teeth hurt immediately after eating candy or drinking soda, there’s a good chance root sensitivity is to blame.
Root sensitivity occurs when things like acidic foods have made your dentin more porous. When this happens, brushing your teeth wears away dentin, causing sensitivity.
Grinding your teeth can lead to tooth sensitivity and toothache over time. This trauma to the tooth can weaken enamel and dentin, leading to more frequent tooth decay.
The weaker your dentin, the more likely you are to wind up with a painful fracture that causes a toothache.
Damaged or Lost Filling
If a dental filling falls out or becomes damaged, it may cause a toothache when sensitive dentin is exposed.
Schedule a dental appointment right away if this happens. As saliva remineralizes the newly exposed dentin, the pain may begin to subside. However, this is not a permanent fix and your tooth will still need repair.
Adult or Wisdom Teeth Eruption
Any form of teething has the potential to cause pain, but wisdom teeth (“third molars”) coming in is most likely to cause a toothache. Any adult or wisdom tooth may not have enough space to come in and put pressure on nearby teeth, causing tooth pain.
Often, pain from wisdom teeth comes from food impaction issues caused by teeth crowding or impaction. This may cause a cavity to form, as the teeth are not ideally seated next to one another and may create a space more likely to develop decay.
If you suffer from gum disease (periodontal disease), it’s likely that gum recession will expose the upper parts of your tooth root, which can hurt very easily when exposed to hot or cold.
Gum disease, the first sign of which is bleeding gums, can eventually lead to more frequent cavities, food getting stuck in teeth, and generally painful dental issues.
Sinus Infection (Sinusitis)
Inflammation or infection of the sinuses can cause tooth pain from sinus pressure and drainage. Usually, this pain is isolated to upper teeth near the back of your mouth (closest to your sinuses).
An infected tooth may also be a cause of sinusitis, so it’s important to work with your dentist and primary care physician to determine which issue is the root cause of your tooth pain.
Pain in your temporomandibular joint (TMJ), also known as TMD, usually affects your jaw. However, over time, it may cause aching in your teeth from referred pain.
Failed Dental Work
Pulpitis, which may or may not be reversible, can cause toothache after dental work. If you’ve recently had a new filling or other dental work done, talk to your dentist about your painful symptoms.
Food Stuck in Teeth
If food gets stuck between your teeth, it can cause pain and sensitivity around where your tooth connects to your gum line. This is more common if you suffer from receding gums.
This is technically not a true “toothache”, as it causes pain in your gums and only feels like a toothache. It’s usually easy to clear food between teeth with a piece of knotted floss.
Failure to dislodge food may lead to tooth decay.
When to See a Dentist
Depending on your symptoms, a toothache might require immediate attention, an exam within the next few weeks, or simply a follow-up with your dentist at your next cleaning.
Schedule an emergency dental appointment immediately if:
- Your tooth pain is severe enough to interfere with normal activities like eating, sleeping, or talking
- Your toothache lasts for 1-2 days or more
- You are also experiencing fever, pain on opening your mouth wide, or an earache
- Your face seems to have fallen, is drooping, or looks distorted in any way
- You can’t breathe or swallow normally
If your dentist doesn’t get back with you within an hour or so and you experience the above symptoms, go to the nearest emergency room.
Call your dentist for an appointment in the next few weeks if:
- Your toothache is isolated to 1-3 teeth (rather than pain throughout your mouth)
- You notice bleeding gums or other signs of gingivitis along with your tooth pain
- Your tooth pain started after an injury to your mouth, face, or jaw
- You lost or damaged an existing filling
If your tooth pain is mild, associated with a sinus infection, clears up with a nasal decongestant, and/or can be reversed by adjusting the foods you eat, it’s probably not cause for an additional dental appointment.
But it’s still a good idea to talk about your tooth pain with your dentist at your next cleaning.
Home & Natural Remedies for Toothache
While they may not be a great severe toothache remedy in many cases, there are several natural remedies that can help stop a toothache at home:
- Warm salt water rinse
- Clove essential oil
- Cold compress
- Peppermint tea
- Knotted floss (for food stuck in teeth)
- Guava leaves
- Wheatgrass juice
How to Sleep with a Toothache
Other home remedies for toothache may help reduce the more extreme pain of a toothache at night so you can still sleep well:
- Pain relievers: Ibuprofen (or aspirin) can both reduce painful tooth symptoms by reducing inflammation temporarily.
- Topical numbing agents: You can use topical gels or pastes to numb the tooth if your pain is related to an exposed nerve. These are usually products that use benzocaine, such as Orajel. These are not safe for children under the age of 2.
- Elevation: If you elevate your head higher than the rest of your body, your toothache may not be as severe. Lying flat can often worsen tooth pain caused by cavities or dental abscesses.
- Avoid triggering foods: Hard/sharp foods (like sourdough bread), acidic, or very cold foods can irritate or worsen tooth pain. Stay away from these foods, especially in the evening.
- Use an ice pack: Before you go to sleep, use a cold compress wrapped in a cloth on the outside of whichever side your tooth pain is worst to dull the ache. It works by shrinking the blood vessels that add to the inflammatory response.
If your toothache won’t go away, it’s a sign that your dentist needs to identify the cause of your pain and correct it.
To diagnose the cause of a toothache, your dentist may:
- Perform a physical examination of your teeth, mouth, and gums
- Use an x-ray or cone-beam CT (CBCT) to look for areas of decay or abscess
- Ask for details about your symptoms, such as the type, location, and severity of your pain, when it began, what makes it worse, and what offers you pain relief
Once your dentist has determined what caused your toothache, he or she will prescribe treatment.
Depending on the root cause of your toothache, the treatment will differ.
Treatments for tooth pain include:
- Filling: A dental filling is used for small-to-medium cavities in which the infected tooth can be cleaned out while leaving the tooth root alive.
- Extraction: Your dentist may perform a tooth extraction to treat a fractured tooth, large cavity, or tooth abscess. In most cases, you will need to plan for a dental implant later to fill the space left behind.
- Wisdom tooth extraction: Particularly for impacted wisdom teeth (which cause a lot of pain), you may need wisdom teeth surgery to relieve the pressure causing pain.
- Root canal: A root canal may be performed when irreversible pulpitis occurs due to a large cavity and/or tooth abscess. Often, but not always, an excruciating toothache is a signal that you require a root canal or an extraction.
- Antibiotics: To shrink a large bacterial infection inside your tooth, your dentist (or an emergency room doctor) may prescribe antibiotics before your final dental procedure. Antibiotics do not cure toothaches or cavities; they temporarily reduce the size of the infection to diminish pain and allow for deferred treatment.
- Abscess drainage: For a gum abscess, your dentist may be able to drain, clean, and treat it for pain relief.
- Desensitizing toothpaste: If you suffer from tooth root sensitivity, you may be prescribed a toothpaste that may block some pain after multiple applications.
- Topical fluoride: Your dentist may prescribe a topical fluoride varnish and/or prescription fluoride toothpaste to rebuild enamel and strengthen your dentin if you have root sensitivity. However, consider hydroxyapatite toothpaste as an alternative, as it is just as effective as fluoride in many cases.
- Gum disease treatment: After a diagnosis of gum disease, your dentist may prescribe scaling & root planing (deep teeth cleaning), flap surgery, or pinhole surgery, depending on the extent of your concerns.
- Prescription mouthwash: Rinsing with chlorhexidine mouthwash may be prescribed to kill the bacteria in your mouth and temporarily relieve toothache. This may lead to additional problems by disrupting your oral microbiome, however, so be sure to use oral probiotics afterward to rebuild a healthier balance of oral bacteria.
- Knotted floss: If you have food stuck between your teeth, knotting a piece of floss and pulling it through the space may be a quick and easy remedy for tooth pain.
- TMJ treatment: You may need to work with both your dentist and primary care provider (or another TMJ specialist) to correct the root cause of TMJ pain.
- Bruxism treatment: Treatment for bruxism ranges broadly, but one of the most common causes is sleep apnea. Talk to your dentist and doctor about getting a sleep study to find out if this is what’s causing your toothache.
How to Prevent Toothache
The best way to prevent toothache is to prevent cavities and other oral health problems like gum disease. Toothache prevention includes:
- A tooth-friendly, nutrient-dense diet
- Proper toothbrushing technique using gentle, circular motions with a soft-bristled brush
- Daily flossing and tongue scraping
- Use of oral probiotics (especially if you have evidence of dysbiosis of your oral microbiome)
- Oil pulling
- Mouth taping
- Teeth cleanings every 6 months
Toothache Remedies to Avoid
After over 3 decades as a dentist, I’ve seen many patients try toothache remedies that make oral health problems much worse in the end.
Do not use the following remedies for a toothache:
- Hydrogen peroxide: Hydrogen peroxide should never be used in the mouth. It is highly antibacterial, which means it disrupts the oral microbiome. Hydrogen peroxide may increase your risk for oral cancer, though sources disagree.
- Aspirin applied to the tooth: Aspirin pills held against the tooth is a less common urban myth that will not improve your tooth pain but will cause ulceration of your teeth, mucosa, and tongue. As you might imagine, this is quite painful — not something you want to add on top of an excruciating toothache.
- Rubbing alcohol: This is a common “remedy” for toothaches that will do more harm than good. It aggressively denatures oral mucous, which can cause canker sores. Plus, it’s not even a great toothache reliever!
- Undiluted essential oils: I don’t recommend using most essential oils in the mouth because they are often highly antibacterial. However, clove oil can be a beneficial, temporary way to get pain relief from a toothache. But any time you use an essential oil like clove in the mouth, it must be diluted greatly before you apply it. Avoid other essential oils, particularly very potent ones like oregano, as these may actually burn the sensitive soft tissues of your mouth.
- Anything claiming to “kill the tooth nerve”: You cannot kill your own tooth nerve at home. Only a dental professional can properly and safely remove the dental pulp, containing nerves, during a root canal procedure.
Why does my toothache come and go?
Sometimes, pain comes and goes as it responds to a temporary stimulus, like hot, cold, or sugar.
Other times, it might be an abscess flaring up and then healing enough that the pain subsides, even if the infection itself isn’t completely gone.
Cracked teeth also often have acute pain that fades and recurs as the pulp inside the tooth gets irritated or infected, heals, and then gets irritated again.
Can a toothache cause a headache?
Yes. The trigeminal nerve is responsible for carrying messages for almost all toothaches as well as headaches, which often means that toothaches can be directly responsible for headaches.
Additionally, we often tense up other areas of the body like the jaw when our teeth hurt, which can lead to headaches. Other problems, like sinus infections, can sometimes radiate as both toothaches and headaches.
When do you need to take an antibiotic for tooth pain?
Typically, you’ll get a prescription antibiotic if your dentist suspects or finds infection.
This is also a common prescription for the period of time before a root canal, in order to get the large infection under control before opening the tooth.
I’m taking amoxicillin for a toothache and it isn’t helping. What can I do?
Many tooth infections are resistant to amoxicillin. Connect with your doctor or dentist again and ask about changing your prescription to another kind of antibiotic.
When I prescribe amoxicillin to my patients, I tell them to contact me if their pain hasn’t improved within 3 days so that we can get them on a different treatment.
I’ve had a toothache for a month and nothing is working, but the pain only comes at night when I get ready to go to bed. What can I do to make it stop?
First, see a dentist. You’re likely dealing with an abscessed tooth that needs medical attention. It won’t heal on its own.
The pain is probably worse at night because you’re laying down, which increases the blood pressure to your tooth since it’s at the same level as your heart.
You can try elevating your head and even your upper torso at night to relieve the pain, but that will only help relieve the pain a little. Ultimately, it’s important that you get treatment so your body can properly heal.
Prognosis & Outlook
Toothaches can be some of the most severe pain you ever endure, but the good news is that they are almost always reversible with the right treatment. Most tooth pain happens as a result of cavities, and most cavity restoration procedures only require a day or two for recovery.
By following good prevention strategies and addressing a toothache as soon as it happens, you will be well on your way to pain-free living again.
- Patel, N. A., & Ferguson, B. J. (2012). Odontogenic sinusitis: an ancient but under-appreciated cause of maxillary sinusitis. Current opinion in otolaryngology & head and neck surgery, 20(1), 24-28. Abstract: https://pubmed.ncbi.nlm.nih.gov/22157162/
- Rashed, H. T. (2016). Evaluation of the effect of hydrogen peroxide as a mouthwash in comparison with chlorhexidine in chronic periodontitis patients: A clinical study. Journal of International Society of Preventive & Community Dentistry, 6(3), 206. Full text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4916793/
- Weitzman, S. A., Weitberg, A. B., Stossel, T. P., Schwartz, J., & Shklar, G. (1986). Effects of hydrogen peroxide on oral carcinogenesis in hamsters. Journal of Periodontology, 57(11), 685-688. Abstract: https://www.ncbi.nlm.nih.gov/pubmed/3104570
- Munro, I. C., Williams, G. M., Heymann, H. O., & Kroes, R. (2006). Use of hydrogen peroxide‐based tooth whitening products and its relationship to oral cancer. Journal of Esthetic and Restorative Dentistry, 18(3), 119-125. Abstract: https://www.ncbi.nlm.nih.gov/pubmed/16831183